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25 Cards in this Set

  • Front
  • Back

Soft first heart sound

Causes: Mitral incompetence, mitral regurgitation

Rheumatic nodules

A local swelling or tissue lump, usually rather firm to touch

Causes: Rheumatic arthritis

Pulses Bigeminus

A cardiovascular phenomenon characterized by groups of two heartbeats close together followed by a longer pause. The second pulse is weaker than the first.

Causes: AV block

Erythema marginatum

Red rings with a raised margin and flat center that are not painful or itchy, usually found on the trunk and proximal extremities. May come and go for several months

Causes: Rheumatic fever

Janeway Patches

Small, non-tender palmar/planter macules

Causes: Infective endocarditis


Swelling of the optic disk tcaused by raised intracranial pressure

Causes: tumour, intracerebral hemorrhage

Diastolic rumble

Low-pitched, rumbling, mid diastolic murmur. Best heardd with the patient on their left side, using the bell over the apex. Accentuated by exercise

Causes: mitral stenosis, triuspid stenosis (rarely)

Pulsus Bisferiens

AKA biphasic pulse

A pulse with two strong systolic peaks separated by a mid systolic dip when palpated. The valsalva maneuver can precipitate

Causes: aortic valve regurgitation, aortic regurgitation with stenosis, HOCM


Loss of sense of smell, sometimes accompanied by altered ability to tase

Causes: sinusitis, nasal congestion, damage to olfactory filaments after head injury, local nerve compression or invasion by skull base tumours, Parkinson's, Huntington's

Pill Roll Movement

A rest tremor in which the fingers and wrist move in a manner reminiscent of a rhythmic voluntary manipulation of small objects in the hand, e.g. pills.

Causes: Chlorpromazine teratogenicity, Creutzfield-Jakob disease, dysphasic demensia, HIV/AIDs, Haloperidol teratogenicity, Multiple system atrophy, Paraneoplastic syndrome, Multiple system atrophy, Parkinson's

Waterhammer pulse

Colapsing pulse, when peak is felt early followed by rapid descend. Exaggerated by lifting the patients arm above their heart

Causes: Physiological (fever, pregnancy), aortic regurgitation, patent ductus arteriosis, systolic hypertension, bradycardia, aotiopulmonary window, rupture of sinus of valsala into heart chambers, cor pulmonale, anemia, cirrhosis, beriberi (thiamine - Vit B1 deficiency), thyrotoxicosis, Atreriovenous fistula, Pagets disease, Chronic alcoholism

Widely split S2

Delay between aortic and pulmonary valves closing

Causes: physiological (inspiration), right bundle branch block (variable with respiration), ASD (fixed),

Erythema nodosum

Painful dusky blue-red nodules commonly seen in lower legs due to vasculitis is deep dermis and subcutaneous fat

Causes: Infections (TB, streps, brucellosis, leprosy, mycoplasma, rickettsia, chlamydia), Drugs (COC's, sulphonomides), sarcoidosis, ulcerative colitis, Crohn's


The perceptual disturbance experienced by some migraine or epilepsy sufferers before an attack


Flat pinhead-sized macules of extravascularised blood in the dermis. Larger are caled purpura and may be palpable. When involving deeper structures it is called ecchymosis. Petechia of the face and eyes are seen in asphyxia

Causes: Infections (Cerebral malaria, congenital syphilis, Crimean-Congo hemorrhagic fever, Dengue fever, Ebola, Endocarditis, H1N1, Hanta virus, Marburg virus, Rocky mountain spotted fever, scarlet fever, typhus), hypocalcemia idiopathic thombocytopenic purpura, leukemia, aplastic anemia, Kwasiorkor, Marasmus, Henoch-Schonlein purpura

Mask like face

Expressionless face with little or no sense of animation. Also called mask like facies

Causes: Parkinson's, depression, facioscapulohumeral type muscular dystrophy, Prader-Willi disease, infantile botulism, Wilsons disease and myotonicdystrophy


Writing motions that are slower and more sustained than chorea

Causes: Wilson's, Huntington's, Porphoria, cerebral birth injury, cerebral trauma, drugs (levodopa, dopamine agonists, phenothiazides, tricyclic antidepressants, COC's), Pregnancy, thyroxicosis, hypoparathyroidism, hypoglycemia


Calcium levels below 3.5mmol/L or 9mg/dL

Symptoms: Tetany in hands feet or throat, carpopedal spasm, depression, numbness of and and feet and around the mouth, fits, perioral tingling and paresthesia, Chvoseks signs, hyperactive reflexes, laryngospasm, cardiac arrhythmias, ECG changes, prolonged QT or ST intervals

Causes: Chronic renal failure, pancreatitis, parathyroid disease


Premalignant, white lesions of the mucous membrane of the oral cavity that are adherent (cannot be scraped off).

Diagnosis of exclusion - candidiasis or lichen planus

Kerley-B lines

Kerley Lines: Thin linear pulmonary opacities caused by fluid or cellular infiltration into the interstitium of the lungs. Sign seen on chest X-rays with interstitial pulmonary oedema

Kerley B lines: short parallel lines at lung periphery. Represent interlobular septa, usually less than 1cm, parallel to each other and at right angles to the pleura. Located peripherally in contact with the pleura but absent along fissural surfaces. Most frequently seen at the lung bases at the costophrenic angle on a PA radiograph and substernal on a lateral radiograph

Causes: Congestive heart failure, interstitial lung diseases

Positive PPD/Tine test

AKA Mantoux screening test, Tuberculin Sensitivity test, Pirquet test, PPD test for Purified Protein Derivative

Diagnostic tool for TB. Positive = TB exposure

>5mm positive in - HIV, recent TB contact, persons with nodular or fibrous changes on X-Ray in keeping with old healed TB, patients with organ transplants or who are otherwise immunosupressed

>10mm positive in - recent arrivals (<5 years) from high risk countries, injection drug users, residents and employees in high risk settings, mycobacteriology lab personal, children <4, persons with chronic disease that put them at high risk

>15mm positive - people with no known risk factors for TB

Froin Syndrome

A sign of blockage of CSF flow. Lumbar puncture shows CSF with high protein level, xanthochromia but normal cell count

Causes: Spinal TB, advanced spinal tumour, spinal meningitis


A macular red or purple hemorrhage, >2mm in diameter, in skin or mucous membrane

Causes: injury or trauma, aging skin, leukemia, anticoagulants (warfarin, heparin, aspirin), steroids, septicemia

Barrel chest

Increased AP diameter, tracheal descent and decreased chest expansion

Causes: chronic hyperinflation e.g. COPD, kyphosis

Arcus Corneals

White or grey crescent shaped opacity at periphery of cornea. It results from cholesterol deposits in or hyaline degeneration of the corneal stroma

Causes: may be associated with ocular defects or with familial hyperlipidemia